急性缺血性脑卒中患者血浆TAFI和炎性因子水平的变化及意义

Changes and significance of thrombin activatable fibrinolysis inhibitor and proinflammatory cytokines in patients with acute ischemic stroke

目的探讨急性缺血性脑卒中(AIS)患者血浆凝血酶激活的纤溶抑制物(TAFI)和炎性因子水平变化,并阐述二者之间的联系,为AIS早期诊断或风险因素评估奠定实验基础。方法选取临床确诊的AIS患者86例为AIS组,以86例健康体检者为对照组。TAFI测定采用免疫比浊法,白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)测定采用酶联免疫吸附试验,C-反应蛋白(CRP)和降钙素原(PCT)测定采用胶体金免疫层析法。结果 AIS患者血浆TAFI水平较对照组显著下降[(17.48±2.79)μg/mL vs.(27.23±3.27)μg/mL],炎性因子IL-1β、IL-6和TNF-α水平显著升高[(10.14±2.05)pg/mL vs.(4.54±0.78)pg/mL;(110.10±11.12)pg/mL vs.(81.18±7.58)pg/mL;(13.02±1.61)pg/mL vs.(6.90±1.55)pg/mL],急性期蛋白CRP和PCT也显著升高[(0.80±0.11)ng/mL vs.(0.43±0.10)ng/mL;(16.41±2.41)μg/mL vs.(5.60±1.11)μg/mL],差异均有统计学意义(P<0.05)。两组血浆TAFI水平与相应炎性因子及急性期蛋白水平呈显著负相关(P<0.05)。结论 TAFI对慢性血管内炎性反应有抑制作用;TAFI有可能成为辅助诊断早期AIS或评估其风险性的生物标志物。

Objective To investigate the serum level of thrombin activatable fibrinolysis inhibitor （TAFI） and inflammatory cytokines in patients with acute ischemic stroke （AIS）,and to explore their relationship,as well as in order to lay an experimental foundation to early diagnosis or risk factor assessment of AIS.Methods A total of 86 acute ischemic stroke patients were selected as AIS group,and 86 cases of healthy people were selected as control group.Serum TAFI level was determined by immunoturbidimetry.Serum interleukine-1β （IL-1β）,interleukine-6 （IL-6） and tumor necrosis factor-α（TNF-α） levels were determined by enzyme-linked immunosorbent assay （ELISA）.Serum proclcitonin （PCT） and C-reactive protein （CRP） levels were determined by colloidal gold immunochromatography.Results Serum TAFI level in AIS group was significantly lower than that of the control group [（17.48±2.79）μg/mL vs.（27.23±3.27）μg/mL],（P〈0.05）.Serum IL-1β,IL-6,TNF-α,PCT and CRP levels in AIS group [（10.14±2.05）pg/mL vs.（4.54±0.78）pg/mL;（110.10±11.12）pg/mL vs.（81.18±7.58）pg/mL;（13.02±1.61）pg/mL vs.（6.90±1.55）pg/mL;（0.80±0.11）ng/mL vs.（0.43±0.10）ng/mL;（16.41±2.41）μg/mL vs.（5.60±1.11）μg/mL] were significantly higher than that of the control group.Correlation analysis showed that there was a negative correlation between serum TAFI concentration and IL-1β,IL-6,TNF-α,PCT and CRP levels both in AIS patients and in controls.Conclusion TAFI could inhibit chronic vascular inflammation.The change of TAFI could be considered as a biomarker for AIS diagnosis or high risk assessment factor.